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Creating and printing a CMS 1500 (HCFA) claim form

Creating and printing a CMS 1500 (HCFA) claim form

You can generate CMS 1500 claim forms to submit electronically, or download and print completed forms to submit outside of SimplePractice.
In this guide, we'll cover:

Note: Before you create your first claim form, make sure that you've entered all of your practice and client information accurately, so it populates into your claim forms correctly. For more information, see Getting started with insurance billing.


Creating a CMS 1500 form

You can create CMS 1500 claim forms individually, or in batches. 

To create an individual CMS 1500 form for a client:

  • Navigate to the client's Billing page
  • Set the date range for the appointments you want to include on the claim form 
  • Click New > Claim/CMS1500

newclaim.simplepractice.billing.png

  • Select the appointments you’d like to include on the claim

chooseappointments.simplepractice.createclaim.jpg

Note: You can include up to six appointments/services codes on a single claim. For more information, see Billing insurance with multiple service codes.

  • Click Create Claim
  • Review the auto-populated information on the claim and add or edit any fields necessary
  • Click Save

To create claims in batches:

  • Navigate to your Calendar > Insurance > Unbilled appointments
  • Set the date range for the appointments you want to include on the claim form 
    • Tip: You can filter by payer, clinician, and note status
  • Select the appointments you’d like to include on the claim
  • Click Create > Create claims

After being created, you can review the claims from your Claims tab. For more details, see Creating batch claims.

Note: The layout that you see your new claim form in is for editing purposes. Once printed, your claim form will appear like a normal CMS 1500 form. For more information on auto-populating additional fields, see What additional fields can be enabled?


Printing your CMS 1500 form

After saving your claim form, you can submit it electronically through SimplePractice, or download it to print.

To download and print your claim form:

  • Open the claim
  • Click the download icon 
    • Select Download complete form if you want to generate the full, red CMS 1500 form as a PDF
    • Select Download field entries only if you want to only generate the data fields so you can print it onto a blank CMS 1500 form

Important: If you are downloading a secondary claim form, you will notice that the downloaded PDF does not match that of the claim form you see in SimplePractice. That is because certain boxes like 8 and 24 where you would enter the client's COB information are specific to SimplePractice and filing secondary claims electronically. These fields are not present when you download the claim as they are not required since secondary claims filed by mail usually are accompanied by a physical primary EOB.

downloadclaim.simplepractice.insurance.png

Note: When creating a claim, box 31 will be blank. A signature isn’t required when filing claims electronically. If you’ll be downloading and filing the claim by mail or fax, you’ll need to manually sign box 31 in order for the payer to successfully process the claim. 

To submit your claim electronically instead, click Submit. To learn more about electronic claim filing, see Filing primary claim in SimplePractice.


Tips for printing your claim form 

  • When printing the claim form, make sure the printer doesn’t scale the page or add margins.
  • When printing the full claim form with the red background, make sure your red ink cartridge is full and the red background prints without any streaks or faded color.
  • When printing the data directly onto a blank claim form, we recommend adding the blank claim form to your printer's main paper tray, as opposed to an auxiliary paper tray.
  • Remember that each printer is different. If your data fields don't print perfectly onto the blank claim form, you may have to adjust the way you load the blank forms in the paper tray. 

We recommend reaching out to your insurance payer directly if you have questions about the requirements for submitting printed CMS 1500 forms.

Note: There isn't a fee for creating and downloading claims. For more information on claim filing fees, see SimplePractice pricing and subscription FAQs

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